Breast implants with anatomical morphology can be filled with silicone gel or physiological saline. In some cases, the filling is a mixture of silicone gel and saline. The surface which surrounds this filling, whatever it may be, is called the cover. The cover is made by adding silicone layers and leaving them to dry. Each manufacturer has its own way of making the cover, although the standard is that the final surface in these anatomical implants is texturized. There are manufacturers who add a polyurethane cover to this texturization. In the case in which the anatomical implants are used as expanders with the aim of reconstructing the post-mastectomy breast, these have on their rear face a valve with a metallic component which allows their positioning from the exterior and the filling in series by means of transcutaneous injections.
Smooth anatomical implants are not commercialized since their surface would not be adherent and they would have displacements or rotations in all cases. In the case of the texturized anatomical breast implants, the pore of the texturization itself produces an adherent effect which prevents rotations in some cases but not in all. The deeper the pore, the more aggressive the texturing, and the greater theoretic adherence it has. However, deeper pores also have more problems over the medium and long term such as delayed seroma and capsular contracture.
For these reasons, an anatomical implant may be micro-texturized. However, micro-texturized anatomical implants rotate more frequently, although they have few incidences of capsular contracture and delayed seroma.
The surgical technique wherein a dissection is entirely customized to the anatomical implants offers fewer rotations over the short and medium term.
In many cases, although the surgeon carries out a dissection customized to the implant, there are factors inherent to the particular patient, such as the elasticity of the tissue or physical exercise which cause the dimensions of this pocket to become modified with time and thus cause rotations of the implants.
On the other hand, the fact that these anatomical implants usually rotate, causes many surgeons all over the world to not use them regularly in spite of the fact that the aesthetic results are always more natural when the surgery is carried out with these implants compared to the results of other round implants.
There are no real statistics available for the percentage of rotations or the average degree which an implant rotates since the manufacturers do not add any device to the anatomical implants which may facilitate the detection, from the exterior of the patient, of this hypothetical rotation over the medium and long term.
All of the rotations of anatomical implants are resolved by an additional surgical intervention when this rotation is not resolved by external maneuvers. In the majority of the cases, the external maneuvers do not resolve the rotation and the patient has to return for surgical intervention.
In the cases of minor rotations, many times these are tolerated because the deformity is minimal and the patients prefer to accept a minor deformity and thus avoid reintervention.
Thus, in the field of breast implants with anatomical morphology, there are currently two problems:                The rotation of the implants        Lack of means for allowing, from the exterior by way of a radiological exam or similar, to check whether the implant is positioned correctly or whether, on the contrary, it has rotated.        